Low anterior resection (LAR) is a common surgical treatment for rectal cancer in which the cancerous segment of the rectum is removed and remaining segments of the rectum are reconnected. This procedure is commonly performed using minimally-invasive surgical techniques. Upon completion of an LAR surgery, the surgeon may want to perform a post-operative trans-anal examination of the suture line within the rectum, or the anastomosis. One purpose of the endoluminal examination is to confirm that the tissue surrounding the anastomosis is well perfused with blood, as such perfusion indicates that the healing process will be successful and that leaks (e.g., leaks of fecal matter into the peritoneum and resulting complications) are less likely to occur. Failure of the anastomosis, often taking the form of anastomotic dehiscence, is a devastating complication of LAR surgery. In the short term, sepsis resulting from fecal leaks can result in acute effects, and even death. Long term morbidities associated with anastomotic failure include stricture formation, bowel dysfunction and an increased chance of cancer recurrence. Ischemia of the tissue surrounding the anastomosis is the likely cause of the majority of complications. Accordingly, accurate post-operative examination of the anastomosis may be crucial to avoid these complications.
The post-operative endoluminal examination is commonly performed with the use of a conventional endoscopic imaging device such as a sigmoidoscope, proctoscope, rectoscope, or colonoscope, etc. There are modern fluorescence-capable laparoscopes that offer several advantages over these conventional instruments, such as higher camera resolution (e.g., high-definition image capability) and the added functionality of tissue perfusion assessment. However, these laparoscopes do not include many practical features that are useful for endoluminal examination. Most notably, these laparoscopes lack the ability to insufflate the rectum, as well as the ability to wash and aspirate fluids from the endoluminal surface to facilitate proper imaging of the anastomosis. To solve this problem, such modern laparoscopes may be used in combination with a surrounding introducer device providing these additional capabilities.
Existing laparoscope introducers typically suffer from the inability to adequately prevent the laparoscope lens from becoming obscured by debris during the insertion of the laparoscope/introducer combination into the rectum, and during the examination procedure itself. Such contamination or occlusion may interfere with visibility during the examination and make it difficult to perform a thorough and accurate assessment of the tissue in the body cavity. As a result, the endoluminal instrument must be removed, cleaned, and reinserted at intervals during the procedure, which complicates the examination procedure and wastes time.
Thus, an endoluminal introducer device and method for using an endoluminal introducer device that reduce the likelihood of debris contaminating and obscuring the laparoscope lens during an examination procedure of a body cavity are desirable.